Tang R, Liu S X, Mao S, Zhang W T
Department of Otorhinolaryngology Head and Neck Surgery, Shanghai JiaoTong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Apr 7;56(4):351-355. doi: 10.3760/cma.j.cn115330-20200605-00477.
To investigate the diagnosis and surgical treatment of sinonasal phosphaturic mesenchymal tumor (PMT). The medical records of nine patients who had been diagnosed as sinonasal PMT in Department of Otorhinolaryngology Head and Neck Surgery, Shanghai JiaoTong University Affiliated Sixth People's Hospital between January 2015 and May 2020 were collected, including 4 males and 5 females, ranging from 36 to 59 years. The patient's previous history, clinical manifestations, imaging findings, laboratory results, surgical procedure, pathological results and postoperative follow-up data were analyzed by descriptive statistical analysis. All patients presented hypophosphatemia and tumor-induced osteomalacia (TIO) with a disease course of 1 to 19 years. The imaging examination and intraoperative findings identified two cases with peripheral tissue infiltration, two cases with contralateral nasal cavity invasion, and one case with intracranial invasion. Five patients underwent unilateral endoscopic resection while two patients underwent bilateral endoscopic resection, and the remaining two patients underwent unilateral transorbital ethmoid artery ligation plus endoscopic tumor resection and endoscopic combined with transfrontal tumor resection (=1 each). Expect for one case developed recurrence and intracranial involvement, the other patients achieved clinical remission and no recurrence was observed during the six-month follow-up. The diagnosis of sinonasal PMT needs combination of clinical manifestation, imaging, and pathological findings. Complete surgical excision and long-term postoperative follow-up are imperative.
探讨鼻窦磷酸酶性间叶性肿瘤(PMT)的诊断及外科治疗方法。收集2015年1月至2020年5月在上海交通大学附属第六人民医院耳鼻咽喉头颈外科被诊断为鼻窦PMT的9例患者的病历资料,其中男性4例,女性5例,年龄36~59岁。采用描述性统计分析方法,对患者的既往史、临床表现、影像学表现、实验室检查结果、手术方式、病理结果及术后随访资料进行分析。所有患者均表现为低磷血症和肿瘤诱导的骨软化症(TIO),病程1~19年。影像学检查及术中发现2例有周围组织浸润,2例有对侧鼻腔侵犯,1例有颅内侵犯。5例行单侧鼻内镜下切除术,2例行双侧鼻内镜下切除术,其余2例分别行单侧经眶筛动脉结扎加鼻内镜下肿瘤切除术及鼻内镜联合经额肿瘤切除术。除1例复发并出现颅内累及外,其余患者均达到临床缓解,随访6个月无复发。鼻窦PMT的诊断需要结合临床表现、影像学及病理检查结果。必须完整切除肿瘤并进行长期术后随访。